Shiwakoti Enesh, Song Jianning, Li Jun, Wu Shanshan, Zhang Zhongtao
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, P.R. China.
J Int Med Res. 2020 Sep;48(9):300060520957547. doi: 10.1177/0300060520957547.
This study was performed to identify risk factors for anastomotic leakage (AL) and combine these factors to create a prediction model for the risk of AL after laparoscopic rectal cancer resection.
This retrospective study involved 185 patients with rectal cancer who underwent laparoscopic resection from March 2012 to February 2017. Five risk factors were analyzed by multivariate analysis. A prediction model was established by combining the risk factors from the multivariate analysis, and the accuracy of the model was evaluated by a receiver operating characteristic curve.
The overall AL rate was 17.84%. The multivariate analysis identified the following independent risk factors for AL: high body mass index (odds ratio [OR], 3.009; 95% confidence interval [CI], 1.127-7.125), preoperative radiochemotherapy (OR, 3.778; 95% CI, 1.168-12.219), larger tumor size (OR, 2.710; 95% CI, 1.119-6.562), and longer surgical time (OR, 2.476; 95% CI, 1.033-5.932). We established a prediction model that can evaluate the risk of AL by determining the predictive probability. The area under the curve for the model's predictive performance was 0.70 (95% CI, 0.598-0.795).
A prediction model was created to predict the risk of AL after laparoscopic rectal cancer resection.
本研究旨在确定吻合口漏（AL）的危险因素，并将这些因素结合起来创建一个预测模型，以预测腹腔镜直肠癌切除术后发生AL的风险。
这项回顾性研究纳入了2012年3月至2017年2月期间接受腹腔镜切除术的185例直肠癌患者。通过多因素分析对五个危险因素进行了分析。结合多因素分析中的危险因素建立了一个预测模型，并通过受试者工作特征曲线评估该模型的准确性。
总体AL发生率为17.84%。多因素分析确定了以下AL的独立危险因素：高体重指数（比值比[OR]，3.009；95%置信区间[CI]，1.127-7.125）、术前放化疗（OR，3.778；95%CI，1.168-12.219）、肿瘤较大（OR，2.710；95%CI，1.119-6.562）和手术时间较长（OR，2.476；95%CI，1.033-5.932）。我们建立了一个可以通过确定预测概率来评估AL风险的预测模型。该模型预测性能的曲线下面积为0.70（95%CI，0.598-0.795）。
创建了一个预测模型来预测腹腔镜直肠癌切除术后发生AL的风险。
